News round-up (20 October 2023)

A new guideline from NICE recommends that the rehabilitation given to stroke victims should increase from 45 minutes to three hours a day, so that they can regain speech and movement. MPs, meanwhile, have called for GPs to offer women over 40 a menopause health check, after research found that only 12% have the menopause diagnosed by a doctor. Some good news for men with prostate cancer, as the trial of a new drug finds that it can shrink tumours in advanced cases of the disease.

NHS told to offer stroke patients extra rehabilitation

Updated guidelines from the National Institute for Health and Care Excellence (NICE) say that the NHS should offer stroke patients extra rehabilitation.

The guideline’s previous recommendation had been for 45 minutes of rehabilitation a day. It now says, however, that some patients may need more intensive therapy for recovery and recommends they receive three hours a day, five days a week.

NICE says the new recommendation may be “challenging,” to meet but that patients deserve the best care possible. That care includes helping patients regain speech, movement and other functions damaged during a stroke.

Dr Maeva May of the Stroke Association told the BBC it was “vital” that governments “act urgently to address staffing issues across health and social care, and within rehabilitation services, and share detailed plans to support and resource them, so that these recommendations can become a reality.”

Nitrous oxide possession to be illegal

The possession of nitrous oxide, also known as laughing gas, will be made illegal in three weeks – and those who repeatedly misuse the drug will face up to two years in prison.

People who deal in nitrous oxide, one of the most commonly used recreational drugs among young people, will face up to 14 years in prison, the Home Office said.

The ban will come into force on 8 November, making nitrous oxide a controlled Class C drug under the Misuse of Drugs Act 1971. This follows a vote by MPs last month.

Frequent use of nitrous oxide can lead to vitamin B12 deficiency which can cause neurological damage, a government report found.

Penalties for possessing the substance could include an unlimited fine, community service or a caution, while prison will be reserved for repeat offenders.

Campaigners say women over 40 should be offered menopause health check

Women who turn 40 should be offered a menopause health check by their GP, according to the all-party parliamentary group (APPG) on menopause.

The APPG says that the NHS should incorporate questions about symptoms into the midlife MOTs already provided by GPs.

A survey of 2,000 menopausal women found that only 12% were diagnosed by a health professional, with most realising they were going through the menopause after carrying out their own research.

Just one quarter had a positive experience discussing the matter with their GP, the survey found.

The APPG said that the checks should be used to ask women about perimenopausal or menopausal symptoms and to make sure they received appropriate treatment either then, or when needed.

New treatment for prostate cancer shrinks cells

A new treatment for prostate cancer has been found to shrink tumours in a clinical trial.

The treatment involves targeting “feeder” cells, which are co-opted by tumours to speed up cancer growth. The research, carried out by the Institute of Cancer Research and the Royal Marsden, and published in Nature, found that resistance to treatment could be reversed.

Researchers tested two drugs in combination: AZD5069, an experimental drug which prevents myeloid cell recruitment to tumours, and enzalutamide, a hormone therapy commonly used to treat prostate cancer. The drugs were given to 48 patients with advanced prostate cancer.

The treatment worked by blocking messages that cancer uses to “hijack” white blood cells and advance disease. It means that some advanced prostate cancers became amenable to treatment, with tumours shrunk by a third.

A quarter of patients saw their tumours shrink by more than 30%, with dramatic decreases in circulating levels of prostate-specific antigen (PSA), a marker secreted by the prostate which is often elevated by cancer.

Thousands of unpaid carers struggle financially, research finds

Thousands of unpaid carers are being forced into poverty because of the cost of living crisis, research from Carers UK suggests.

The organisation’s State of Caring 2023 survey found that 75% of unpaid carers receiving carer’s allowance are now struggling with cost-of-living pressures, almost half (46%) are cutting back on essentials including food and heating and 45% are struggling to make ends meet.

The research also showed that, of carers receiving carer’s allowance, 34% are struggling to afford the cost of food, 71% are worried about living costs, 72% are worried about the impact of caring responsibilities on their finances (e.g. petrol for hospital visits, heating, dietary requirements) and 54% had cut back on seeing family and friends.

Helen Walker, the chief executive of Carers UK, said: “Carers, and particularly those who are receiving Carer’s Allowance, are extremely vulnerable to high costs due to their limited ability to earn an income. It is vital that the government immediately overhauls carer’s allowance and increases the rise in the earnings threshold so that carers can continue to earn.”

ChatGPT may be better than GPs at following depression guidelines

ChatGPT, the artificial intelligence tool, may be better than a doctor at following recognised treatment standards for depression, a study suggests.

The research, carried out by researchers from Israel and the UK, was published in Family Medicine and Community Health, the open access journal owned by British Medical Journal. It compared how the AI tool evaluated cases of mild and severe depression with 1,249 French primary care doctors. The researchers used hypothetical case studies of patients with symptoms of sadness, sleep problems and loss of appetite during the previous three weeks and a diagnosis of mild to moderate depression.

Given a choice of treatment responses, ChatGPT’s answers demonstrated greater precision in adjusting treatment to comply with clinical guidelines – and without the gender or social class biases sometimes seen in the physician-patient relationship.